A new study has revealed an alarmingly high rate of critically ill patients in African hospitals, alongside a concerning lack of access to the most fundamental critical care across the continent.
Patients were classified as critically ill if at least one vital sign was severely abnormal. According to the study, published in The Lancet, one in eight hospital patients in Africa is critically ill. Of these, one in five (21 per cent) die within a week, compared to just 2.7 per cent of non-critically ill patients.
The research, conducted by the African Perioperative Research Group (APORG), is the first continent-wide epidemiological study of critical care illness. It surveyed 19,872 patients across 180 hospitals in 22 African countries, including Botswana, Burkina Faso, Egypt, Ethiopia, Ghana, Nigeria, South Africa, and Uganda, among others. Data was collected between 6 September 2023 and 27 December 2023, with the median patient age being 40 years.
Most hospital admissions were acute or emergency cases, with non-communicable diseases being the most common reason for admission.
The study highlights the severe resource shortages faced by African hospitals in treating critically ill patients. A significant proportion of these patients — 69 per cent — are treated in general wards rather than intensive care units (ICUs). Furthermore, more than half (56 per cent) do not receive even the most basic critical care, such as oxygen therapy, intravenous fluids, or simple airway management.
The findings underscore critical gaps in hospital infrastructure, equipment, staffing, training, treatment guidelines, consumables, and medications needed to effectively manage critically ill patients. For instance, Africa has fewer than one ICU bed per 100,000 people, compared to 34 and 29 per 100,000 in the USA and Germany, respectively.
The study calls for urgent investment in low-cost, lifesaving interventions to reduce mortality rates.
The African Critical Illness Outcomes Study (ACIOS) serves as a wake-up call for healthcare systems across the continent, emphasising the need to prioritise essential emergency and critical care. By focusing on high-impact, low-cost solutions, health systems can significantly improve survival rates without requiring extensive investments in ICU infrastructure.